Fiscall Yearr 20200

F
CERTIIFICA
ATION OF F REG GISTR
RATIO
ON
This certiffies that: 

Shenzheen Jiebosh
hi Medicaal Technology CO.,, Ltd
2 Floor No
N 4 Jianngfa Road
d Jianglingg Commu
unity Ma Luan Strreet Pingsshan
District Shenzhen
n City
has complleted the FDDA Establishhment Regiistration and
d Device Listing with tthe US Food
d & Drug
Administrration, throuugh 

Sh
henzhen HUAK
H Testing Technology Co., Ltd.. 

Ownerr/Operattor Number: 100065102

Devicee Listing##: See an
nnex
Shenzhen HUAK willl confirm thatt such registraation remains effective uponn request andd presentation of
this certificatee until the endd of the calenddar year stated above, unlesss said registrration is termiinated after
issuance of thhis certificate. Shenzhen HU
UAK makes no
n other repreesentations or warranties, nnor does this
certificate maake any repressentations or warranties
w to any person orr entity other than the nameed certificate
holder, for whhose sole beneefit it is issuedd. This certificcate does not denote
d endorssement or appproval of the
certificate-hoolder’s device or establishm
ment by the U.SS. Food and Drug
D Administtration. Shenzzhen HUAK
assumes no liiability to any person or enttity in connecttion with the foregoing. 
f
 
Pursuant to 21 CFR 8007.39, “Registtration of a deevice establish
hment or assiggnment of a reegistration
number does not in any waay denote apprroval of the esstablishment or
o its productss. Any represeentation that
mpression of off
creates an imp fficial approvaal because of registration or
o possession of
o a registratiion number is
misleading annd constitutes misbranding..” The U.S. Foood and Drug
g Administration does not isssue a certifica
ate
of registrationn, nor does the U.S. Food and
a Drug Adm
ministration reecognize a cerrtificate of reggistration,
Shenzhen HU
UAK is not affiiliated with thee U.S. Food and
a Drug Adm
ministration.

____________
_______ 
Chief Enginneer
Issued: March 31, 2020 
Expiration D
Date: December 31, 2020
 Fiscal Year 2020
CERTIFICATION OF REGISTRATION

Annex to Device Listing# for Owner/Operator Number: 10065102

Listing Code Device Name Activities Proprietary Name

No.

D380657 KHA MASK, Disposable Respirator

Manufacturer Type B
SCAVENGING

END OF THE ANNEX

_________________ 
Chief Engineer
Issued: March 31, 2020 
Expiration Date: December 31, 2020